Minimally Invasive Implant and Crimping System

ABSTRACT

A device for treating a bone comprises a cable block including a first lumen extending from a first proximal opening in a proximal face of the cable block to a first distal opening in a distal face thereof, the first lumen being configured to receive a cerclage cable including an enlarged end. The cable block further includes a second lumen extending from a second proximal opening in the proximal face to a second distal opening in the distal face and being configured to receive a portion of the cable extending from the enlarged end while preventing the enlarged end from passing therethrough. The cable block includes a slot connecting distal portions of the first and second lumens and being at least as large as the second lumen in combination with a crimpable locking member including a channel configured to receive the portion of the cable extending from the enlarged end.

PRIORITY CLAIM

This application claims priority to U.S. Provisional Application Ser.No. 61/083,546 entitled “Minimally Invasive Implant for PeriprostheticFractures” filed on Jul. 25, 2008, U.S. Provisional Application Ser. No.61/084,298 entitled “Minimally Invasive Crimp and Cable, ItsCrimping-Cutting Tool and the System to Do it” filed Jul. 29, 2008 andU.S. Provisional Application Ser. No. 61/085,437 entitled “MinimallyInvasive Crimp and Cable, Its Crimping Tool and the System to Do it”filed on Aug. 1, 2008. The entire specifications of the above-identifiedapplications are expressly incorporated herein by reference.

FIELD OF THE INVENTION

The present invention relates to the treatment of a bone and, inparticular, to a minimally invasive treatment of a fracture by circlinga cable around the fractured bone and crimping a crimp over the cable tohold the cable in place via a small incision through the skin.

BACKGROUND

Peri-prosthetic fractures of the femur are common injuries that may bevery difficult to treat. For example, a previously placed implant mayinterfere with the healing or placement of other bone fixation elements.One system of treating a peri-prosthetic fracture loops a cable aroundthe bone to secure a fractured portion of the bone. These cables areoften used in conjunction with implants that may be positioned along thebone to provide stability to the bone. However, the cables often slidealong the implant which may result in difficult positioning the cableabout a desired area of the bone. In addition, securing the cable afterit has been looped around the bone often requires a large surgicalapproach, which may result in greater risks to the patient.

SUMMARY OF THE INVENTION

The present invention is directed to a device for treating a bonecomprising a cable block including a first lumen extending from a firstlumen proximal opening in a proximal face of the cable block to a firstlumen distal opening in a distal face of the cable block, the firstlumen being sized and shaped to slidably receive therethrough a cerclagecable including an enlarged end, the cable block further including asecond lumen extending from a second lumen proximal opening in theproximal face of the cable block to a second lumen distal opening in thedistal face of the cable block, the second lumen being sized and shapedto receive therethrough a portion of the cable extending from theenlarged end while preventing the enlarged end from passingtherethrough, the cable block including a slot connecting distalportions of the first and second lumens, the slot being at least aslarge in diameter as the second lumen in combination with a lockingmember including a channel sized to slidably receive the portion of thecable extending from the enlarged end and a proximal abutting surfaceconfigured to abut a portion of a proximal face of the cable blocksurrounding the second lumen proximal opening, the locking member beingformed of a material crimpable over the cable to fix the locking memberat a desired position on the cable.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows a perspective view of a system according to an exemplaryembodiment of the present invention;

FIG. 2 shows a enlarged perspective view of a portion of the system ofFIG. 1;

FIG. 3 shows an enlarged perspective view of a portion the system ofFIG. 1;

FIG. 4 shows a perspective view of a bone plate of the system of FIG. 1;

FIG. 5 shows a perspective view of a cable of the system of FIG. 1;

FIG. 6 shows an enlarged perspective view of a first end of the cable ofFIG. 5;

FIG. 7 shows a top perspective view of a cable block of the system ofFIG. 1;

FIG. 8 shows a bottom perspective view of the cable block of FIG. 7;

FIG. 9 shows a top plan view of the cable block of FIG. 7;

FIG. 10 shows a side view of the cable block of FIG. 7;

FIG. 11 shows another side view of the cable block of FIG. 7;

FIG. 12 shows a bottom plan view of the cable block of FIG. 7;

FIG. 13 shows a perspective view of the cable and the crimp of thesystem of FIG. 1;

FIG. 14 shows a side view of the cable and the crimp of the system ofFIG. 1;

FIG. 15 shows a perspective view of a crimping device according to afirst exemplary embodiment of the present invention, in an openconfiguration;

FIG. 16 shows a side view of the crimping device of FIG. 15, in the openconfiguration;

FIG. 17 shows a perspective view of a first sleeve of the crimpingdevice of FIG. 15;

FIG. 18 shows a top view of the first sleeve of FIG. 17;

FIG. 19 shows a side view of the first sleeve of FIG. 17;

FIG. 20 shows a perspective view of a second sleeve of the crimpingdevice of FIG. 15;

FIG. 21 shows a top view of the second sleeve of FIG. 20;

FIG. 22 shows a side view of the second sleeve of FIG. 20;

FIG. 23 shows a perspective view of a third sleeve of the crimpingdevice of FIG. 15;

FIG. 24 shows a top view of the third sleeve of FIG. 23;

FIG. 25 shows a side view of the third sleeve of FIG. 23;

FIG. 26 shows a side view of the crimping device of FIG. 15, in acrimping configuration;

FIG. 27 shows a perspective view of a distal end of the crimping devicein the crimping configuration of FIG. 26;

FIG. 28 shows a side view of the crimping device of FIG. 16, in acutting configuration;

FIG. 29 shows a perspective view of the distal end of the crimpingdevice in the cutting configuration of FIG. 28;

FIG. 30 shows a perspective view of a crimping device according to asecond exemplary embodiment of the present invention, in an openconfiguration;

FIG. 31 shows a side view of the crimping device of FIG. 30, in the openconfiguration;

FIG. 32 shows a perspective view of an first sleeve of the crimpingdevice of FIG. 30;

FIG. 33 shows a side view of the first sleeve of FIG. 32;

FIG. 34 shows a plan view of a distal end of the first sleeve of FIG.32;

FIG. 35 shows a perspective view of an second sleeve of the crimpingdevice of FIG. 30;

FIG. 36 shows a side view of the second sleeve of FIG. 35;

FIG. 37 shows a plan view of a distal end of the second sleeve of FIG.35;

FIG. 38 shows a perspective view of a distal end of the crimping deviceof FIG. 30, in the open configuration;

FIG. 39 shows a plan view of the distal end of the crimping device inthe open configuration of FIG. 38;

FIG. 40 shows a perspective view of the distal end of the crimpingdevice of FIG. 30, in a crimping configuration;

FIG. 41 shows a plan view of the distal end of the crimping device inthe crimping configuration of FIG. 40;

FIG. 42 shows a perspective view of a crimping device according to athird exemplary embodiment of the present invention;

FIG. 43 shows a side view of the crimping device of FIG. 42;

FIG. 44 shows a perspective view of an first sleeve of the crimpingdevice of FIG. 42;

FIG. 45 shows a side view of the first sleeve of FIG. 43;

FIG. 46 shows an enlarged perspective view of a distal end of the firstsleeve of FIG. 43;

FIG. 47 shows a perspective view of an second sleeve of the crimpingdevice of FIG. 42;

FIG. 48 shows a side view of the second sleeve of FIG. 47;

FIG. 49 shows an enlarged perspective view of the second sleeve of FIG.47;

FIG. 50 shows an enlarged perspective view of the crimping device ofFIG. 42, in an open configuration; and

FIG. 51 shows an enlarged perspective view of the crimping device ofFIG. 43, in a crimping configuration.

DETAILED DESCRIPTION

The present invention may be further understood with reference to thefollowing description and the appended drawings, wherein like elementsare referred to with the same reference numerals. The present inventionrelates to the treatment of a bone and, in particular, to a minimallyinvasive treatment of a bone fracture. Exemplary embodiments of thepresent invention describe a system and method for treating a fractureof a bone by circling a cable around the fractured bone and crimping acrimp over the cable to hold the cable in place via a small incisionthrough the skin. Although exemplary embodiments of the presentinvention specifically describe a periprosthetic fracture, it will beunderstood by those of skill in the art that the present invention maybe used to treat other fractures as well and that this procedure isexemplary only. It will also be understood by those of skill in the artthat the terms proximal and distal, as used herein, describe a directiontoward (proximal) and away from (distal) a surgeon or other user.

As shown in FIGS. 1-14, a system 100 according to an exemplaryembodiment of the present invention comprises a plate 102 positionablealong a bone 108, a cable 104 that circles the plate 102 and the bone108 and a crimp 105 that fixes the cable 104 at a desired tension aboutthe plate 102 and the bone 108. As shown in FIGS. 1-3, the plate 102 maybe positioned along a length of the bone 108, which may include aprosthesis 112, to provide stability to a fracture 110 of the bone 108.The cable 104 may be circled around both the plate 102 and/or the bone108 to fix the fracture 110. The crimp 105 further comprises a cableblock 106 that receives a portion of the cable 104 therethrough and adeformable member 150 that may be positioned adjacent the cable block106 to be crimped over the cable, fixing the cable 104 about the bone108 at a desired position and tension.

As shown in FIG. 4, the plate 102 extends longitudinally from a firstend 114 to a second end 116 and includes a first surface 118 facing awayfrom the bone 108 and a second surface 120 facing toward the bone 108.The bone plate 102 may include a plurality of openings 122 along alength thereof, each of the openings 122 being adapted and configured toreceive a bone fixation element 124. The bone fixation element 124 may,for example, be a variable-angle locking screw, as shown in FIG. 2, or anon-locking screw, as shown in FIG. 3. An edge 126 of the first surface118 includes grooves 128 along a length thereof to receive a width ofthe cable 104 when the cable 104 is circled around the bone 108 suchthat the cable 104 is prevented from sliding along the length of theplate 102.

The cable 104, as shown in FIGS. 5-6, extends longitudinally from afirst end 130 to a second end 132. The first end 130 includes anenlarged end 134 that functions as a stop to prevent the first end frompassing through the cable block 106 such that the cable 104 may be fixedaround the bone 108. The enlarged end 134 may be substantiallycylindrical, with a diameter of the enlarged end 134 being larger than aremaining length of the cable 104 which is sized to pass slidablythrough the cable block 106. It will be understood by those of skill inthe art, however, that the enlarged end 134 may take any of a variety ofshapes such as, for example, a sphere, so long as a maximum width of theenlarged end 134 is larger than a width of the remaining length of thecable 104 to prevent the end 134 from passing through an opening whichslidably receives the remaining length of the cable 104.

As shown in FIGS. 7-12, the cable block 106 includes a first surface 136and a second surface 138. The first surface 136 is shown facing the bone108 while the second surface 138 is shown facing away from the bone 108.It will be understood by those of skill in the art, however, that thecable block 106 may also be positioned such that the first surface 136faces away from the bone 108 while the second surface 138 faces towardthe bone 108. The cable block 106 further includes a first lumen 144 anda second lumen 146 extending therethrough from a proximal end 140 to adistal end 142, substantially parallel to the first and second surfaces136, 138. The first and second lumens 144, 146 are angled relative toone another such that they intersect adjacent to the distal end 142. Thecable block 106 further includes a slot 148 extending into the surfaceof the distal end 142 connecting the first and the second lumens 144,146. The slot 148 extends proximally into the distal end 142 across thegap between the first and second lumens 144, 146 with a width of theslot 148 being approximately equal to a diameter of the second lumen146. That is, a width of the slot 148 is selected to permit the passagetherethrough of the cable 104 but not to permit the passage of theenlarged end 134 thereof. Thus, the first and second lumens 144, 146open to the distal end 142 via a single opening defined by the distalends of the first and second lumens 144, 146 and the slot 148 extendingtherebetween.

The first lumen 144 is sized and shaped to accommodate the cable 104,including the enlarged end 134, therethrough. The second lumen 146 issized and shaped to allow only the remaining length of the cable 104,excluding the enlarged end 134, to pass therethrough. The slot 148includes a first portion aligned with the first lumen sized and shapedto permit the enlarged end 134 to pass therethrough and a second partextending laterally from the first part toward the second lumen 146 witha width substantially equal to a diameter of the second lumen 146. Thus,the enlarged end 134 may pass only through the first part of the slot148. As described below, in a locked position, the enlarged end will bedisplaced laterally to abut the second part of the slot 148 preventingthe enlarged end 134 from passing back through the first lumen 144.

As shown in FIGS. 13-14, the cable block 106 may be used in conjunctionwith the deformable member 150 to crimp the cable 104 over the bone 108.The deformable member 150 may be a short, substantially tubular memberextending from a proximal end 158 to a distal end 156 and including achannel 152 extending therethrough sized and shaped to slidably receivethe cable 104 therein. In use, the deformable member 150 is positionedadjacent an opening of the second lumen 146 at the proximal end 140 ofthe cable block 106 with the distal end 156 of the deformable member 150abutting the proximal end 140 and crushed over the cable 104 fixing thedeformable member 150 at a desired tension about the bone 108. As wouldbe understood by those skilled in the art, the deformable member 150 ispreferably formed of a deformable material such as a biocompatible metalthat may be crushed over the cable 104 extending through the channel152.

The cable 104 may be initially circled around the bone 108 and the plate102. It will be understood by those of skill in the art that the cable104 may be circled around the bone 108 using any of a variety ofcerclage tools. Once the cable 104 has been circled as desired, thefirst end 130 of the cable 104, including the enlarged end 134, isinserted into the first lumen 144, entering via the proximal end 140 andextending distally past the distal end 142. The enlarged end 134 maythen be moved laterally so that a proximal end 154 of the enlarged end134 engages the second part of the slot 148 such that the enlarged endcannot pass proximally therethrough. Engagement of the enlarged end 134with the second part of the slot 148 exposes an opening at the distalend 142 to the second lumen 146 permitting the second end 132 of thecable 104 to be inserted through the second lumen via the distal end 142to extend proximally past the proximal end 140. The second end 132extending past the proximal end 140 may then be threaded through thechannel 152 of the deformable member 150 until the distal end 156 of thedeformable member 150 abuts the proximal end 140 of the cable block 106.

The user then applies tension to the cable 104 to draw the cable 104tightly around the bone 108 pressing the distal end 156 of thedeformable member 150 is pressed against the proximal end 140 of thecable block 106. Once the desired tension has been applied to the cable104, the user may use one of the crimping devices 200, 300, 400, asdescribed below, to crimp the deformable member 150, crushing thedeformable member 150 against the portion of the cable 104 passingtherethrough and fixing the cable 104 around the bone 108 and throughthe cable block 106 at the desired tension.

As shown in FIGS. 15-29, the crimping device 200 according to a firstexemplary embodiment of the present invention comprises a first sleeve202 for holding a portion of the deformable member 140, a second sleeve204 for crimping the deformable member 150 and a third sleeve 206 forcutting the cable 104 adjacent the proximal end 158 of the deformablemember 150. As shown in FIGS. 15-16, the first, second and third sleeves202, 204, 206 are coaxially nested within one another such that each ofthe sleeves 202, 204, 206 is rotatable relative to the others about alongitudinal axis of the crimping device 200. The first sleeve 202 holdsthe deformable member 150 against the crimp 106, with the cable 104extending therethrough, while the second and/or third sleeves 204, 206may be moved relative to the first sleeve 202 to crimp the deformablemember 150 over the cable 104 and subsequently cut the cable 104proximally of the deformable member 150, respectively.

As shown in FIGS. 17-19, the first sleeve 202 includes a firstlongitudinal body 208 extending from a proximal end 210 to a distal end212 and including a first lumen 214 extending therethrough sized andshaped to accommodate a second longitudinal body 226 of the secondsleeve 204. A distal opening 216 of the first lumen 214 is off-centerwith respect to a longitudinal axis of the first longitudinal body 208.The first sleeve 202 further includes a handle 218 extending laterallyfrom the proximal end 210 of the longitudinal body 208. Extending from aside 220 thereof is a quadrant gear wheel 222 including teeth 224 alonga perimeter thereof. The gear wheel 222 extends substantially radiallyabout the longitudinal axis of the first longitudinal body 208.

As shown in FIGS. 20-22, the second sleeve 204 includes a secondlongitudinal body 226 extending from a proximal end 228 to a distal end230 with a second lumen 232 extending therethrough sized and shaped toreceive a third longitudinal body 242 of a third sleeve 206. The secondlongitudinal body 226 is sized and shaped to be received within thefirst lumen 214 of the first sleeve 202. A distal opening 234 of thesecond lumen 232 is off-center of a longitudinal axis of the secondlongitudinal body 226. The second sleeve 204 further includes a handle236 and a ratchet pawl 238. The handle 236 extends laterally of theproximal end 228 while the ratchet pawl 238 is attached to a distalsurface 240 of the handle 236. A length of the second longitudinal body226 is longer than a length of the longitudinal body 208 of the firstsleeve such that when the second longitudinal body 226 is inserted intothe first lumen 214, the distal end 230 abuts the distal end 212 of thefirst longitudinal body 208 and the handle 236 of the second sleeve 204abuts the handle 218 of the first sleeve 202 such that the ratchet pawl238 engages the teeth 224 of the quadrant wheel 222. Thus, it will beunderstood by those of skill in the art that the first sleeve 202 andthe second sleeve 204 are rotatable relative to one another about alongitudinal axis of the crimping device 200. However, engagementbetween the ratchet pawl 238 and the teeth 224 of the quadrant wheelprevent the first and second sleeves 202, 204 from rotatinguncontrollably relative to one another.

As shown in FIGS. 23-25, the third sleeve 206 includes a thirdlongitudinal body 242 extending from a proximal end 244 to a distal end246 and including a third lumen 248 extending therethrough sized andshaped to receive the deformable member 150 and the cable 104 therein.The third longitudinal body 242 may be sized and shaped to be receivedwithin the second lumen 232. The third lumen 248 may be off-center of alongitudinal axis of the third longitudinal body 242. The third sleeve206 further includes a handle 250 extending laterally from the proximalend 244 of the third longitudinal body 242. A length of the thirdlongitudinal body 242 is longer than a length of the second longitudinalbody 226 such that when the third longitudinal body 242 is receivedwithin the second lumen 232, the distal end 246 abuts the distal end 230of the second sleeve 204 and the handle 250 abut the handle 236 of thesecond sleeve 204.

FIGS. 15-16 show the crimping device 200 in an open configuration inwhich the first, second and third sleeves 202, 204, 206 are nested asdescribed above and the off center distal openings 216, 234 of the firstsleeve 202 and the second sleeve 204, respectively are aligned alongwith the off-center lumen 248 of the third sleeve 206 to allow thedeformable member 150, which includes the cable 104 passingtherethrough, to be received therein. In the open configuration, thehandle 218 of the first sleeve 202 may be substantially perpendicular tothe handles 236, 250 of the second and third sleeves 204, 206,respectively. After tension is applied to the cable 104, the crimpingdevice 200 is moved into a crimping configuration, as shown in FIGS.26-27. In the crimping configuration, the handles 236, 250 of thecrimping and third sleeves 204, 206 may be rotated relative to the firstsleeve 202 such that the handles 236, 250 are substantially aligned withthe handle 218 of the first sleeve 202 and the distal opening 234 andthe lumen 248 of the crimping and third sleeves 204, 206 are no longeraligned with the distal opening 216 of the first sleeve 202, therebycrimping the deformable member 150 over the cable 104 and fixing thecable 104 relative to the cable block 106 and the deformable member 150.

Once the deformable member 150 has been crimped by the crimping device200 to fix the cable 104 about the bone 108, the crimping device 200 maybe moved to a cutting configuration, as shown in FIGS. 28-29, to cut thecable 104 adjacent the proximal end 158 of the deformable member 150such that an excess length of the cable 104 is removed. In the cuttingconfiguration, the third sleeve 206 is rotated relative to the firstsleeve 202 and the second sleeve 204 such that the handle 250 issubstantially radially opposed to the handles 218, 236 of the first andsecond sleeves 202, 204, respectively. The third lumen 248 is completelyoff-set from both the distal openings 216, 234 such that the cable 104is cut flush to the deformable member 150. Once the deformable member150 has been crimped and the cable 104 cut, the crimping device 200 maybe removed from the body, along with the excess cable 104.

Similarly to the crimping device 200, a crimping device 300, as shown inFIGS. 30-41, may be used to crimp the deformable member 150 of thesystem 100, as described above, over the cable 104. As shown in FIGS.30-31, the crimping device 300 comprises a first sleeve 302 and ansecond sleeve 304 substantially housed within the first sleeve 302. Thefirst and second sleeves 302, 304 are rotatable relative to one anotherabout longitudinal axes thereof, between an open configuration and acrimping configuration, in which first and second crimping surfaces 318,336 of the first and second sleeves 302, 304, respectively, are movetoward one another to crimp the deformable member 150 therebetween, overthe cable 104. The first and second sleeves 302, 304 may be coupled toone another via a pin 306, adapted and configured to permit the firstand second sleeves 302, 304, respectively, to rotate relative to oneanother while preventing the first and second sleeves 302, 304 frommoving longitudinally relative to one another. The crimping device 300,however, does not include a cutting mechanism. Thus, it will beunderstood by those of skill in the art that any known separate cuttingdevice may be utilized when using the crimping device 300 to cut thecable 104 as desired.

As shown in FIGS. 32-34, the first sleeve 302 includes a firstlongitudinal body 308 extending from a proximal end 310 to a distal end312 and including a first lumen 314 extending therethrough. The firstlumen 314 may be sized and shaped to receive a second longitudinal body324 of the second sleeve 304. A distal opening 316 of the first lumen314 may be substantially semi-circular and sized to permit thedeformable member 150, along with the cable 104 passing therethrough, tobe received therein. The distal opening 316 includes the first crimpingedge 318 tapered relative to a remaining portion of the distal opening316. The proximal end 310 of the first longitudinal body 308 furtherincludes a lateral hole 320 for receiving the pin 306. It will beunderstood by those of skill in the art that the pin 306 and the lateralhole 320 may be correspondingly threaded such that the pin 306 and thelateral hole 320 threadedly engage one another, preventing the pin 306from coming loose during use of the crimping device 300. The firstsleeve 302 may further include a handle 322 extending laterally from theproximal end 310.

As shown in FIGS. 35-37, the second sleeve 304 includes the secondlongitudinal body 324, which extends from a proximal end 326 to a distalend 328 and includes a second lumen 330 extending therethrough. Thesecond longitudinal body 324 is sized and shaped to be received withinthe first lumen 314. The second lumen 330 is sized and shaped toaccommodate the cable 104 and the deformable member 150 therethrough andis off-set from a longitudinal axis of the second sleeve 304 such that adistal opening 332 of the second lumen 330 is not co-axial with thelongitudinal axis of the second sleeve 304. Proximate the distal opening332, the second sleeve 304 further includes a protrusion 334 extendingdistally from the distal end 328. The protrusion 334 may be formed as aportion of a semi-circle such that the protrusion 334 is receivablethrough the distal opening 316 of the first lumen 314, along with thedeformable member 150. The protrusion 334 includes the second crimpingedge 336 on a side thereof facing the distal opening 332 of the secondlumen 330, which may be tapered relative to a remaining portion of theprotrusion 334, to facilitate crimping of the deformable member 150. Thesecond sleeve 304 may further include a handle 338 extending laterallyfrom the proximal end 326 of the second longitudinal body 324.

The second sleeve 304 further includes a groove 340 for receiving aportion of the pin 306, the groove 304 being proximate the handle 338 atthe proximal end 326 of the second longitudinal body 324 and extendingaround at least a portion of a circumference of the second longitudinalbody 324 such that when the second longitudinal body 324 is insertedinto the first lumen 314, the lateral hole 320 and the groove 340 arelongitudinally aligned. Thus, it will be understood by those of skill inthe art that when the first sleeve 302 and the second sleeve 304 arecoupled via the pin 306, the first and second sleeves 302, 304 arerotatable relative to one another but prevented from movinglongitudinally relative to one another. A length of the secondlongitudinal body 324 is preferably selected so that when the secondlongitudinal body 324 is inserted into the first lumen 314 of the firstsleeve 302, the distal end 328 of the second longitudinal body 324 abutsthe distal end 312 of the first sleeve 302 and the handle 338 of thesecond sleeve 304 abuts the handle 322 of the first sleeve 302.

In the open configuration, as shown in FIGS. 38-39, the semi-circulardistal opening 316 of the first sleeve 304 is substantially aligned withthe protrusion 334 and the distal opening 332 of the lumen 330 of thesecond sleeve so that the protrusion 334 extends through the distalopening 316 of the first sleeve 304 and the distal opening 332 of thesecond sleeve 304 is fully exposed to receive the deformable member 150therein. The first crimping edge 318 of the first sleeve 302 and thesecond crimping edge 336 of the second sleeve 304 are positioned onsubstantially opposite sides of the distal opening 332. The handles 322,338 of the first and second sleeves 302, 304, respectively, may beangled relative to one another. In the open configuration, thedeformable member 150 is inserted into the distal openings 316, 332 andthe portion of the cable 104 passing proximally through the deformablemember 150 extends proximally through the lumen 330.

After a desired tension has been applied to the cable 104, the handles322, 338 are drawn toward one another to move the crimping device 300 tothe crimping configuration, as shown in FIGS. 40-41. Drawing the handles322, 338 toward one another rotates the first sleeve 302 and the secondsleeve 304 relative to one another to move the first and second crimpingedges 318, 336 toward one another. The first crimping edge 318 movesover the distal opening 332 crimping the deformable member 150 betweenthe first and second crimping edges 318, 336 over the cable 104, fixingthe cable 104 around the bone 108.

As shown in FIGS. 42-51, a crimping device 400 according to a thirdexemplary embodiment is substantially similar to the crimping device 300described above excepted as noted below. As shown in FIGS. 42-43, thecrimping device 400 comprises a first sleeve 402 and a second sleeve 404nested within the first sleeve 402 such that the first and secondsleeves 402, 404 are rotatable relative to one another about alongitudinal axis of the crimping device 400, between an openconfiguration and a crimping configuration. Similarly to the firstsleeve 302, the first sleeve 402, as shown in FIGS. 44-46, includes afirst longitudinal body 408 extending from a proximal end 410 to adistal end 412 and a handle 422 extending laterally from the proximalend 410. The first longitudinal body 408 also includes a first lumen 414extending therethrough for accommodating a second longitudinal body 424of the second sleeve 404. The first lumen 414, however, does notaccommodate any portion of the deformable member 150 or the cable 104.

The first longitudinal body 408 further includes a groove 416 at thedistal end 412. The groove 416 extends radially about a portion of thefirst lumen 414. To accommodate the deformable member 150 and the cable104, the first sleeve 402 further includes a second lumen 442 extendinglongitudinally through the first longitudinal body 408, substantiallyparallel to the first lumen 414 such that the second lumen 442 extendsthrough the groove 416. The second lumen 442 may extend through thelongitudinal body 424 with a distal end 444 of the second lumen 444adjacent to a first lateral surface 418 of the groove 416.

As shown in FIGS. 47-49, the second sleeve 404 may be substantiallysimilar to the second sleeve 304. The second sleeve 404 includes thesecond longitudinal body 424 extending from a proximal end 426 to adistal end 428 and a handle 438 extending laterally from the proximalend 424. The longitudinal body 424, however, does not include a lumenextending therethrough. Rather, the second sleeve 404 includes anopening 430 through the handle 438, which aligns with the second lumen442 when the crimp device 400 is in the open configuration to receivethe cable 104 therethrough. The second longitudinal body 424 furtherincludes a protrusion 434 that extends radially outward from the distalend 428. The protrusion 434 is sized and shaped so that when the crimpdevice 400 is in the open configuration the protrusion 434 is receivedwithin the groove 416 of the first sleeve 402, while exposing the secondlumen 442. Thus, a second lateral surface 436 of the protrusion 434 doesnot cover any portion of the distal opening 444 of the second lumen 442.

In the open configuration, as shown in FIG. 50, the second lumen 442 isexposed between the first and second lateral surfaces 418, 436 such thatthe deformable member 150 may be received within the distal opening 444.The cable 104 extends through the channel 152 of the deformable member150 and passes proximally through the second lumen 442 of the firstsleeve 402 to extend proximally past the opening 430 in the handle 438of the second sleeve 404. In the crimping configuration, as shown inFIG. 51, the first sleeve 402 and the second sleeve 404 are rotatedrelative to one another about the longitudinal axis such that the secondlateral surface 436 is moved toward the first lateral surface 418 sothat the deformable member 150 is crushed therebetween, thereby crimpingthe deformable member 150 over the cable 104. The first sleeve 402 andthe second sleeve 404 may be rotated relative to one another by, forexample, drawing the handles 422, 438 toward one another.

It will be apparent to those skilled in the art that variousmodifications and variations may be made in the structure andmethodology of the present invention, without departing from the spiritor scope of the invention. Thus, it is intended that the presentinvention cover the modifications and variations of this inventionprovided that they come within the scope of the appended claims andtheir equivalents.

1. A device for treating a bone, comprising: a cable block including afirst lumen extending from a first lumen proximal opening in a proximalface of the cable block to a first lumen distal opening in a distal faceof the cable block, the first lumen being sized and shaped to slidablyreceive therethrough a cerclage cable including an enlarged end, thecable block further including a second lumen extending from a secondlumen proximal opening in the proximal face of the cable block to asecond lumen distal opening in the distal face of the cable block, thesecond lumen being sized and shaped to receive therethrough a portion ofthe cable extending from the enlarged end while preventing the enlargedend from passing therethrough, the cable block including a slotconnecting distal portions of the first and second lumens, the slotbeing at least as large in diameter as the second lumen; and a lockingmember including a channel sized to slidably receive the portion of thecable extending from the enlarged end and a proximal abutting surfaceconfigured to abut a portion of a proximal face of the cable blocksurrounding the second lumen proximal opening, the locking member beingformed of a material crimpable over the cable to fix the locking memberat a desired position on the cable.
 2. The device of claim 1, whereinthe second lumen intersects with the first lumen within the cable blockat an intersection point no further distally than a proximal end of theslot.
 3. The device of claim 1, wherein the slot is substantially equalin diameter to the second lumen.
 4. A system for treating a bonecomprising: a cable block including a first lumen extending from a firstlumen proximal opening in a proximal face of the cable block to a firstlumen distal opening in a distal face of the cable block, the firstlumen being sized and shaped to slidably receive therethrough a cerclagecable including an enlarged end, the cable block further including asecond lumen extending from a second lumen proximal opening in theproximal face of the cable block to a second lumen distal opening in thedistal face of the cable block, the second lumen being sized and shapedto receive therethrough a portion of the cable extending from theenlarged end while preventing the enlarged end from passingtherethrough, the second lumen intersecting with the first lumen withinthe cable block, the cable block including a slot connecting portions ofthe first and second lumens from the distal face of the cable block to aslot end point no further proximally than a point at which the first andsecond lumens intersect; a locking member including a channel sized toslidably receive the portion of the cable extending from the enlargedend and a proximal abutting surface configured to abut a portion of aproximal face of the cable block surrounding the second lumen proximalopening, the locking member being formed of a material crimpable overthe cable to fix the locking member at a desired position on the cable;and a crimping device including a first sleeve and a second sleeve, thefirst sleeve including a first longitudinal body having a third lumenextending longitudinally therethrough, the second sleeve including asecond longitudinal body sized to be housed substantially within thefirst lumen, the second longitudinal body defining a fourth lumenextending therethrough, the crimping device being movable between anopen configuration in which the deformable member and the cable may beslidably received therein and a crimping configuration in which thefirst and second longitudinal bodies are rotated relative to one anotherabout a longitudinal axis of the crimping device to crimp the deformablemember over the cable.
 5. The system of claim 4, further comprising abone plate to be held in a desired position against the bone, the plateincluding a plurality of grooves along an edge of proximal surfacethereof, each of the grooves being sized and shaped to receive therein awidth of a cerclage cable such that the cable is prevented from slidinglongitudinally along the plate.
 6. The system of claim 4, wherein adiameter of a distal opening of the fourth lumen is smaller than adiameter of a portion the fourth lumen extending proximally therefromand is off-center relative to the longitudinal axis, a diameter of adistal opening of the third lumen being smaller than a diameter of aportion of the third lumen extending proximally therefrom and isoff-center relative to the longitudinal axis, the distal openings of thethird and fourth lumens being aligned in the open configuration toreceive the deformable member therethrough and misaligned in thecrimping configuration to crimp the deformable member over the cable. 7.The system of claim 6, the crimping device further including a thirdsleeve including a third longitudinal body housed substantially withinthe second lumen and rotatable relative to thereto into a cuttingconfiguration, the third longitudinal body including a fifth lumenextending therethrough, the fifth lumen being substantially aligned withthe distal openings of the third and fourth lumens when in the openconfiguration and being movable to a cutting configuration in which thefifth lumen is moved out of alignment with the distal openings of thethird and fourth lumens to cut a portion of the cable extendingproximally of the deformable member.
 8. The system of claim 6, whereinthe first sleeve includes a quadrant wheel extending laterally of theproximal end of the first longitudinal body and wherein the secondsleeve includes a ratchet pawl engaging teeth of the quadrant wheel suchthat the first and second sleeves are selectively rotatably locked withrespect to one another.
 9. The system of claim 4, wherein the secondlongitudinal body includes a protrusion extending distally from a distalend thereof, an edge of the protrusion being adjacent to a distalopening of the fourth lumen, a distal opening of the third lumen beingsized and shaped to receive the protrusion and expose the fourth lumenin the open configuration, the deformable member being crimped betweenan edge of the distal opening and the edge of the protrusion as thefirst and second longitudinal members are moved to the crimpingconfiguration.
 10. The system of claim 4, the first longitudinal bodyincluding a sixth lumen and a recess at a distal end thereof extendingradially about a portion of the third lumen, the sixth lumen extendingparallel to the third lumen such that the sixth lumen extends throughthe recess adjacent to a lateral surface thereof, the sixth lumen beingsized and shaped to receive the deformable member and the cable therein,the second longitudinal body including a protrusion extending radiallyoutward from a distal end thereof positioned so that the protrusion isreceived within the recess exposing the sixth lumen when in the openconfiguration, movement of the first and second longitudinal members tothe crimping position crimping the deformable member between a lateralsurface of the protrusion and the lateral surface of the recess.
 11. Thesystem of claim 4, the first sleeve including a first handle extendinglaterally from a proximal end of the first longitudinal body and thesecond sleeve including a second handle extending laterally from aproximal end of the second longitudinal body, the first and secondhandles being arranged such that drawing the first and second handlestoward and away from one another rotates the first and second sleevesbetween the open and crimping configurations.
 12. A method for treatinga bone, comprising: circling a cable around a target bone to be treated,the cable extending from an enlarged first end to a distal end;inserting the enlarged first end of the cable through a first lumen of acable block and passing the second end through a second lumen of thecable block, the first lumen extending from a first lumen proximalopening in a proximal face of the cable block to a first lumen distalopening in a distal face of the cable block, the second lumen extendingfrom a second lumen proximal opening in the proximal face of the cableblock to a second lumen distal opening in the distal face of the cableblock, the cable block further including a slot connecting distalportions of the first and second lumens, the slot having a width sizedto slidably receive the cable therethrough; displacing the enlarged endof the cable laterally through the slot so that the enlarged end of thecable abuts a portion of the slot through which it cannot pass; passingthe second end of the cable through a lumen of a locking member andsliding the locking member over the cable until an end of the lockingmember abuts the cable block; applying a desired tension to the cable;and crimping the deformable member over the cable to fix the cablearound the target bone at the desired tension.
 13. The method of claim12, further comprising positioning a plate along a target portion of thetarget bone with the cable circled about both the bone and the plate tohold the plate against the target portion of the target bone.
 14. Themethod of claim 13, wherein the plate includes a plurality of groovesalong an edge of a surface thereof which faces away from the targetbone, each of the grooves being sized and shaped to receive a width ofthe cable therein to prevent the cable from sliding longitudinally alongthe plate.